Associations of chinese-modified MIND diet with low muscle mass and physical performance among old adults in china: findings from the CLHLS 2018 national survey

BACKGROUND: Despite established health benefits of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet in older populations, its relationship with muscle health remains largely unexplored. This study investigated associations between adherence to a Chinese-modified MIND diet and both low muscle mass (LMM) and physical performance among community-dwelling older Chinese adults. METHODS: Data were drawn from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 13,422 older adults. Muscle mass was assessed using a validated appendicular skeletal muscle mass (ASM) prediction formula. Physical performance was evaluated using a four-item functional assessment scale in reference to SARC-F. The associations between Chinese version of the MIND (cMIND) diet adherence and outcomes were examined using multivariable logistic regression for LMM and linear regression for physical performance. Comprehensive subgroup and sensitivity analyses were conducted to assess effect modification and result robustness. RESULTS: The prevalence of LMM was 45.2% among participants. Higher cMIND diet scores demonstrated significant inverse associations with LMM probability across all analytical models. After full adjustment for sociodemographic, lifestyle, and health-related confounders, participants in the highest tertile of cMIND adherence showed substantially lower odds of LMM compared to those in the lowest tertile (odds ratio [OR]: 0.79; 95% confidence intervals [CI]: 0.69-0.90). Similarly, better cMIND diet adherence was positively associated with higher physical performance score in multivariable models. These findings remained consistent across sensitivity analyses. CONCLUSION: Greater adherence to the cMIND dietary pattern is independently associated with lower probability of LMM and better physical performance among older Chinese adults. These findings suggest potential benefits of promoting MIND diet principles for maintaining musculoskeletal health in aging populations.